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Senior Medical Leaders Testify on Defense Health Care Reform

By Terri Moon CronkDoD News, Defense Media Activity

WASHINGTON, Feb. 24, 2016 — Many successful initiatives are underway to reform the Military Health System, but the system will require change to continue its many benefits to readiness and patient care, military medicine’s top leaders told a Senate panel yesterday.

Dr. Jonathan Woodson, assistant secretary of defense for health affairs; Navy Vice Adm. (Dr.) Raquel Bono, director of the Defense Health Agency; and the Army, Navy and Air Force surgeons general made recommendations to a Senate Armed Service Committee personnel panel on defense health care reform.

“The Military Health System takes great pride in its performance in combat medicine over more than 14 years of war,” Woodson said, adding that the services’ medical collaboration resulted in “a greater than 95 percent survival rate of those wounded from battle.”

And similarly, the ability to prevent disease through primary care created “equally historic outcomes,” he said.

While the medical knowledge from the decade and a half of war in Iraq and Afghanistan yielded many joint-service “best practices,” military medicine must continue to grow, he said.

“The challenges we face in medicine and in national security continue to evolve,” Woodson said, adding that new approaches are needed to be prepared for the future. To meet those challenges, the Military Health System has taken a number of initiatives to gain greater strength in all facets of its responsibilities, he added.

One such effort addresses reforms for TRICARE, the military’s health plan that uses contracted private medical services when military treatment centers are not easily accessible for Defense Department beneficiaries.

*TRICARE Rated No. 1*

Woodson said he was grateful for beneficiaries’ and service organizations’ congressional testimony on the Military Health System.

“The TRICARE benefit was named the No. 1 health plan in the country for customer experience in 2015, owing in no small part the comprehensive coverage and low cost to our beneficiaries,” he said.

“But we’ve heard loud and clear from our beneficiaries that access to primary and specialty care needs attention, particularly at our military treatment facilities,” he added, noting that such concerns already have resulted in steps such as greater access to primary and specialty care.

“We entered 2016 confident the reforms in the Military Health System and [TRICARE] can be further strengthened through a combination of legislative and operational reforms,” Woodson said.

*Defense Health Agency: Collaboration*

The Defense Health Agency was stood up two years ago as a combat support agency to enable all three services to provide a medically ready force to combatant commands during war and peacetime. DHA director Bono said the agency continues to improve military health care quality and safety expectations for beneficiaries in both military treatment facilities and in TRICARE.

“We’re simplifying contracts, reducing management overhead in government and [contracts],” she noted, which would, for example, allow beneficiaries to use urgent care clinics without prior authorization.

“A DHA analytics team [also] will assess performance of MHS using joint measures for readiness, health, quality, safety, satisfaction and cost for leadership at the headquarters and field level,” Bono said.

*Surgeons General on Readiness*

“To ensure readiness, Army medicine must maintain the medical capabilities that are ready to deploy and support our warfighters,” Army Surgeon General Lt. Gen. (Dr.) Nadja Y. West said. West also serves as commanding general for U.S. Army Medical Command.

Improving patient access to care is her priority, she said, adding that she has directed actions to rapidly improve that access.

“‘I understand reforms are necessary to ensure the long-term sustainability of TRICARE,” she said, stressing that reforms should not increase financial burden on beneficiaries or affect readiness.

“Reforms must not degrade our combat-tested system or readiness in an environment where we must remain rotationally focused and surge ready [because] the next large-sale deployment could be tomorrow,” West said.

While the Military Health System has “proven itself time and again [with] the thousands of men and women who are alive today, it is not perfect,” said Navy Surgeon General Vice Adm. (Dr.) C. Forrest Faison III.

“We are committed to continuing necessary reforms … to improve our patients’ experience, and most importantly, their health,” Faison added. “However, we must do so without putting at risk the very system that has yielded unprecedented survival.”

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